Department of Health and Social Care: Unpaid Advisers

Lord Snape Excerpts

Tuesday 17th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, scrutiny of appointments, a commitment to transparency and declaration of interests are absolute values that we should all subscribe to. However, sneering at those who step forward to help, denigrating the intentions of volunteers who try to play their role and smearing the good name of people who have done the right thing does not have any role in this House.

[Lord Snape (Lab)]

My Lords, many years ago, the then political editor of the Sun, Mr Chris Potter, told me that the main qualification for his role was the ability to translate the musings of Ministers at the Dispatch Box for the benefit of his readers without using any words longer than “wheelbarrow”. Now that one of his successors, Mr George Pascoe-Watson, attends confidential departmental meetings, can the Minister tell the House whether the criteria for such a role has been enhanced or dumbed down these days?

[Lord Bethell (Con)]

I thank the noble Lord for his description of the role. I do not endorse it but am entertained by it. Let me be clear: the people who stepped forward and took ministerial appointments brought a wide range of skills, some of them quite soft in terms of networking, energy, the ability to negotiate and understanding the important skills of communication. Those are the kinds of skills that we value. They were provided for free in the instance to which the noble Lord has referred, and were limited in their timescale, scope and interactions with the department.

Covid-19: Response

Lord Snape Excerpts

Monday 27th July 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, local trusts have been urged for many months now to undertake a profound risk assessment of workers, particularly BAME workers, in order to understand where infection may have come from. Infection control teams in individual trusts are charged with the responsibility for delivering infection control plans. It is at that level that we can understand the detailed causes of infection because in each trust those causes can be quite different.

[Lord Snape (Lab) [V]]

My Lords, may I, for the second time in three days, press the Minister on what information is given or not given to local authorities during this pandemic? Is he aware that in the borough of Sandwell last week there were nearly 100 new cases of Covid-19, of which no fewer than 28 were confirmed at a single workplace in West Bromwich? Is he further aware that these 28 cases were discovered not by notification through the Government’s track and trace system but by a telephone call from the relative of one of those infected to Sandwell council’s public health department? Does the Minister agree that workplace addresses must be included in the information given to local authorities nationwide so that councils can act immediately to tackle the problem? Will he ensure that that is done in future?

[Lord Bethell [V]]

My Lords, local authorities have had daily Covid-19 containment dashboards, which include 111, 119, online triage information and positive case information at UTLA and LSOA levels, for more than two weeks. Data for directors of public health who have signed the data-sharing agreement requires data-sharing agreements as personally identifiable information, and is mostly for their teams. That data includes much more granular data, including sex, age, postcode, ethnicity, occupation, test date, pillar and test location type. This question of data is one that concerns us enormously. We have moved a phenomenal amount in recent weeks, and it is my genuine belief that those in local authorities, directors of public of health and local infection teams have all the data that they need to do the job.

Health Protection (Coronavirus, Restrictions) (No. 2) (England) Regulations 2020

Lord Snape Excerpts

Friday 24th July 2020 Lords Chamber

[Lord Snape (Lab) [V]]

My Lords, I will confine my few words to a plea on behalf of local authorities throughout England for information gleaned under the Government’s much-vaunted test and trace programme to be properly shared with those authorities. In the borough of Sandwell in the West Midlands, the public health director, Dr Lisa McNally, has been campaigning for weeks for better access for her team to original data about affected people, including names and workplaces. This would enable her team, and teams countrywide, to swoop in and contact trace in the community instead of having to rely on the flawed national test and trace operation.

So far, her calls and those made by other public health directors across the country have been rejected because of data protection. It is a strange system of data protection that shares information with private companies such as Serco yet refuses that information to local authorities. If that information is not shared, it is not a question of whether we will see a second wave but when.

Tobacco and Related Products Regulations 2016

Lord Snape Excerpts

Tuesday 10th May 2016 Grand Committee

[Lord Stoddart of Swindon (Ind Lab)]

My Lords, I first declare an interest, because this is a tobacco and related products order and I am an associate member of the Houses of Parliament Pipe and Cigar Smokers’ Club. I am an associate member because I am a non-smoker, so they tolerate me. I am pleased to be a member of that club because I believe that the attitude towards smoking has been quite absurd in many respects. Measures have been taken against the smoking population—I am talking about the adult smoking population—that are not appropriate in a democratic society, which should allow adults to make choices about their lifestyle and not be dictated to by government.

However, we are not talking about tobacco today. I only just saw the Prayer from the noble Viscount, Lord Ridley—if it is a Prayer—for the debate that he has instituted today, and I think that he and other noble Lords have really put the case. As far as I am concerned, there is probably nothing else to say, except to give them support in resisting the Government’s, and of course the EU’s, decisions to restrict a product that is going to assist others in giving up tobacco smoking. That is almost impossible to believe: that a Government who have been so anti-smoking, and who have themselves brought in so many anti-smoking measures over the years—I have been involved with them for at least 25 years—should now, when we are on the brink of assisting people to give up tobacco smoking, put these very stringent restrictions upon them. Why on earth are they banning the advertising of them if they are a health benefit to people who smoke and the Government think that people ought to give up smoking? To me, that seems to be an absolutely absurd position.

Have there been consultations with the producers of what are called e-cigarettes, but perhaps that was a mistake because they are not cigarettes? Anyone who mentions cigarettes is immediately jumped on by the Government and the department, so it may have been a mistake to label them as cigarettes since they clearly are not and should not be treated as such. Have Ministers had discussions with these producers? I ask that question because the department and Ministers refuse even to meet and have discussions with the tobacco companies. Perhaps that is understandable because the World Health Organization recommends that they should not be given a voice. However, in this case it is something that will help people to give up tobacco. Again, have they had discussions with the people who produce e-cigarettes? I should like to know the answer to that.

The only other thing I have to say is this. I hope that the Government will listen to this debate, although in fact there is not much hope of that because in the past trying to get the Government to listen to reason is like banging your head against a brick wall. It does not matter what you say. They have their policies, but when they get into government, they often change them. I can remember sitting on the other side of the Moses Room and listening to a former health Minister speaking—not voting—against some of the measures that were being introduced by the Labour Party. An example of those was the hiding of cigarettes behind blinds. He was against that, and indeed I well remember him meeting with retailers and saying how a Conservative Government would see that that was repealed. But of course they are in government now and so they are in favour of it, and they have brought forward this legislation. It is not about banning a dangerous product like cigarettes; it is about a product which helps people to stop smoking.

So I hope that the Minister will listen carefully to the experiences of those who have spoken in this debate. I should add that I have met many people, including a relative of mine, who had been heavy smokers but were weaned off smoking by using e-cigarettes. I am obliged to the noble Viscount, Lord Ridley, for seeing to it that we have had a proper debate and I hope that the Government will listen to it.

[Lord Snape (Lab)]

My Lords, I should start by apologising to the noble Viscount, Lord Ridley, for missing the first few minutes of his speech. I appear to be a dupe to the railway industry at the moment. Today’s excuse for the cancellation of my train was a broken windscreen, which I thought was pretty unique. It was a 125 mile-an-hour Pendolino, so I suppose that the windscreen ought to be intact for the whole of the journey.

I agree very much with what has been said from both sides. I do not have any financial or personal interests to declare, although at the age of 74 I know that my generation are habitual smokers. I was surrounded by smokers. Both my parents smoked and, when I went to work for the railway industry, virtually everybody I worked with smoked. However, unlike the noble Lord, Lord Brabazon, or the noble Earl, Lord Cathcart, I managed to find the will-power to give up about 30 years ago. I did it purely by terrifying myself. It became apparent that smoking was synonymous with lung cancer. I convinced myself that every cigarette I lit was the one that was going to give me lung cancer, so eventually I terrified myself into stopping.

However, I do not understand the purpose of this SI or the fact that we are going to ban products that will help people to give up smoking. Like other speakers, I do not believe that someone who is currently a non-smoker will move from vaping to tobacco. Surely it has been proved, or is obvious enough, that people move the other way—from tobacco to vaping—and I cannot understand why the Government are so ready to accept this SI. That is not to say that I am getting involved in what is going to happen on 23 June.

There is a group of people whom the Government ought to be concerned about regarding smoking in the future. As I go round the country, I am concerned about the number of young people who smoke, particularly the number of young women, many of whom believe that smoking helps them to stay fairly slim—I was going to say “fit”, although obviously it does not do that. Anything that would help them to come off tobacco would be good. I have no doubt that the two medical doctors who will reply for both sides will tell us that there is no scientific evidence that smoking keeps you trim. However, I again quote my own experience. I put on a stone and a half quite quickly when I gave up smoking. There was no medical reason for that. It is a fact that smokers are anxious to put down their knives and forks and head for the door to have a cigarette immediately after the main course. Once I gave up smoking, I stayed for the ice cream and puddings and so on. So I want to know from the medical profession, from both sides of the Room, which will kill me first—smoking or my spare tyre. Understandably, I have been warned about both.

Mention was made by the noble Lord, Lord Callanan, of the reduced-risk tobacco products, such as the “heat-not-burn” products, which I understand the industry is currently looking at. I understand that the Chancellor mentioned these products in his recent Budget. I would be interested to know from the Minister what the Government’s intentions are. I fear that if the Treasury acts in the way that it usually acts under any Government, it will be another excuse to tax something as heavily as possible. However, if we are serious—which we are—about weaning people off the demon that is tobacco, then banning alternative products which are proven to be less dangerous is a far from sensible way forward, and I would be interested to hear from both Front Benches why they are apparently supporting this SI.

--- Later in debate ---

[Lord Prior of Brampton]

I think that the hesitation comes because for a number of years the evidence around vaping was not clear. Many distinguished scientists felt that it was potentially harmful; it was not just the tobacco lobby. It is now absolutely clear, as I said earlier—I am unequivocal about this—that vaping is far more preferable to smoking. That does not alter the fact that quitting altogether, either smoking or vaping, is probably the best outcome.

[Lord Snape]

The noble Lord, Lord Callanan, and I mentioned the “heat-not-burn” products. I know that strictly speaking they are not covered by the SI but, as I understand it, they are covered by the legislation emanating from Brussels as a whole. As the Chancellor mentioned in his Budget that he was looking at an alternative to cigarettes, I wonder whether the Minister can comment on the Government’s future intentions.

[Lord Prior of Brampton]

If that is on the taxation point, I am not aware of any intentions to tax these products. I will find out more about that question and write to the noble Lord but, as things stand, I am not aware of any intention to do so.

--- Later in debate ---

[Viscount Ridley]

My Lords, I will be brief because I know that other noble Lords are waiting to start the next debate. I am most grateful to all those who have spoken in the debate: my noble friends Lord Brabazon, Lord Callanan and Lord Cathcart; the noble Lords, Lord Stoddart, Lord Hunt and Lord Snape; the noble Earl, Lord Erroll; and my noble friend Lord Prior. I say to the noble Lord, Lord Snape, that he looks in extremely good shape. He did not get the advice he was looking for about his health and I am not medically qualified, but he looks fine to me.

[Lord Snape]

I apologise for interrupting, but what are his medical qualifications in reassuring me?

[Viscount Ridley]

I withdraw the advice.

I agree with the noble Lord, Lord Stoddart, and the noble Earl, Lord Erroll, that we need to change the vocabulary in this area. Indeed, I myself now use the phrase vaping device rather than e-cigarette whenever possible because it makes more sense and it is a shorter term. I was also fascinated to recall when listening to the noble Earl, Lord Erroll, how one kept awake on motorways before Red Bull was invented. I did not realise that cigarettes had that effect. The noble Lord, Lord Hunt, has put his finger on it. There is still a real issue of public confusion, which we have seen reflected in recent opinion polls. Over the past couple of years, people’s suspicions about these products have increased because of the misinformation in the studies that were cited by others. The issue of harm is a tricky one to get across to the public because you cannot say that vaping is absolutely safe or that it is good for you. Vaping devices are certainly good for smokers, but in absolute terms they are not good. However, that is not the point. The point is relative harm and harm reduction.

I had originally wanted to put down a regret Motion to express stronger dissatisfaction with the directive and the way it is being brought into law, but the best chance of getting a debate before the end of the Session was through a take note Motion. I am sure that the Grand Committee wants to take note. Perhaps I may make a couple of other brief points. My noble friend Lord Brabazon mentioned that smoking is very regressive at the moment: it bears down much more heavily in terms of cost and suffering on poorer people than richer people. It is no longer an equal opportunity killer, if I can put it that way.

I am most grateful to my noble friend the Minister for the very different tone in his response from that of his predecessor, when we first debated this matter some two years ago in this Room, and for his unequivocal statement that it is a good thing for smokers to take up vaping. I was also encouraged to hear him make the point, and I will press him on it as we go forward, that although the directive prevents advertising, it does not prevent public information campaigns to get the point across to smokers. With that, and the promise of Italian light-style implementation, I beg to move.

NHS: White Paper

Lord Snape Excerpts

Monday 12th July 2010 Lords Chamber

[Earl Howe]

My Lords, I am grateful to the noble Baroness for her positive comments. On public health, she will see in the White Paper that we will be publishing a further White Paper later in the year specifically about public health. Quite deliberately, there is only limited information on that subject in this White Paper. As regards choice of provider, she will see in the White Paper that our policy is clear: it is a policy of “any willing provider”. That means that any provider who is able to provide services to the NHS at the right level of quality and at or below the tariff will be allowed to do so. However, as I said in the Statement, this will not be a free-for-all because providers, if they provide services to the NHS, will be subject to the scrutiny of Monitor, and there will be a joint licensing system between Monitor and the CQC in respect of financial systems and quality, so that those providers who offer their services to the NHS will be regulated on a level playing field. I shall take away the concern she raised at the end of her question, and if I have not covered it adequately in my answer, I will write to her.

[Lord Snape]

Does the Minister accept that this is not a reorganisation of the National Health Service being proposed by the Government, but a balkanisation of that service? Did he not notice the lack of enthusiasm for these proposals of those on the Benches behind him, particularly his junior partners in this alliance? Where is the sense in taking away powers from primary care trusts and strategic health authorities and giving them to individual GPs—ironically, to those in the one group who are not employees of the National Health Service? How will it be possible to continue with a unified National Health Service throughout the United Kingdom if hundreds, if not thousands, of GP practices all promote their own ideas in their own specific areas? These proposals will kill the National Health Service, as the Government well know. Why their allies are supporting them, only they will know.

[Earl Howe]

My Lords, I am not sure what the noble Lord’s question was but I profoundly disagree with his analysis of the proposals before the House. Far from killing off the National Health Service they will give it added life. What is the National Health Service about? It is there to serve patients. If we take as our guiding principle that patients matter more than anyone else—more than the system and more than PCTs—and that we want to take care of patients in the best possible way, we need to enable doctors and patients, working together, to take ownership of the patients’ state of health and to take decisions together. If you arrive at that conclusion, the structures that we are proposing are the logical outcome. The noble Lord’s concerns are for the system, which has often got in the way of patient care. The whole point of these proposals is to remove those obstacles. I hope he will have cause to change his mind as he reads the White Paper.